Form 1162

Aviation Reference Number (ARN)

Application - Individual

IMPORTANT INFORMATION FOR APPLICANTS

1. Use this form to apply for an Aviation Reference Number (ARN) for an individual. If you require an organisation ARN complete
Form 1170.
2. If you have previously been provided with an ARN and do not remember the number please contact CLARC on 131 757.
3. In order to utilise CASA’s online services as an ARN holder or apply for an aviation medical, you must provide a valid individual
email address in Section 3. If you require an aviation medical, private information will be sent to the email address provided.
Therefore, to ensure privacy is maintained CASA will not accept your ARN application if you provide a generic email address.
4. Fields marked with an (*) are mandatory for this application.
PLEASE READ THE GUIDELINES PRIOR TO COMPLETING THIS FORM AND ENSURE THAT YOU INCLUDE ANY
REQUIRED IDENTIFICATION.

Privacy Statement: Any personal information you provide to CASA is protected by the Privacy Act 1988 (Cth). CASA can only
collect, use and disclose that information in accordance with that Act. CASA will use the information collected in this form for
purposes associated with performing its functions under the Civil Aviation Act 1988, the Airspace Act 2007, the Aviation Transport
Security Act 2004 or the regulations made under those Acts. For full details on how CASA collects, protects and uses personal
information, please refer to CASA’s Privacy Policy.

Section 1: Personal Details *

Family Name Given Name Other Names

Previous Family Name Previous Given Names

Gender Male Female Title Date of Birth

Nationality

Section 2: Address Details *

Residential Address
(Must be your current place
of residence, PO Box not Suburb
accepted)
State Postcode Country
Postal Address
(If different to Physical
Address) Suburb

State Postcode Country

Section 3: Contact Details

Phone Mobile Fax

Email Email Address

Provided:
Reason Email Address not Provided:
………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………….
Section 4: Proof of Identity *
Type of ID Australia Citizenship Change of name
Passport Birth Certificate
attached Certificate identification (if required)
Section 5: Applicant’s Declaration

I hereby declare that the particulars set out in this application are true in every respect and the copy of the attached
identification document is a true representation of the original and has not been altered in any way. Note - there are penalties
for providing false and misleading information and may result in prosecution, fines and cancellation of civil aviation
authorisations.
I am aware and accept the risk that information sent via email may be intercepted and read during transmission, not delivered
or modified.
I have read CASA's policy on the collection and release of information and I authorise CASA to release information
contained on this form in accordance with that policy.
Print Name: * Signature: * Date: ____ / ____ / _____

Form 1162 12/2017 Aviation Reference Number (ARN) Application - Individual Page 1 of 2
Aviation Reference Number (ARN) Application - Individual

Guidelines for Aviation Reference Number (ARN) Application

Who should use this form?
Any individual who needs to apply for an Aviation Reference Number (ARN).
If you have been issued with an ARN previously and do not know the number please contact CASA Licensing
and Registration Centre (CLARC) on 131 757 to obtain details.
Identification
A copy of one piece of identification must be supplied with this application. Acceptable forms of identification
are birth certificates (full or extract), passport identification pages (may be expired within the last 12 months)
or Australian Citizenship Certificates. A drivers’ licence is not an acceptable form of identification.
The identification supplied must be in English, be clear and legible. Documents not in English must be
accompanied by a certified translation. The translation must be compiled by a translator registered within the
National Accreditation Authority for Translators & Interpreters Ltd (NAATI) and must include the NAATI
translator’s stamp.
It is not necessary to supply certified copies of identification. Identification is required to avoid the creation of
duplicate ARNs and to ensure that the correct, full, legal name, date of birth and nationality are recorded.
Where information recorded on this application differs from the proof of identity documentation the ARN
created will reflect the details off the proof of identity documentation provided.
If you are unable to provide one of the acceptable forms of identification please contact CLARC on 131 757 or
clarc@casa.gov.au
Previous names or future name changes
If you have previously changed your name, please write your previous name on the application form and
supply a copy of the legal name change document (eg reissued birth certificate, including the section listing
previous names; certificate of name change; marriage certificate etc.). If there is insufficient space in the
previous name field, please attach a covering note with the additional information.
If you change your name at any stage in the future, including name change due to marriage, deed poll or
divorce, you must inform CASA and supply a copy of the legal name change documentation. You may also
be required to provide a statutory declaration and pay any fees associated with the reissue of documents such
as medical certificates, flight crew licences, ASICs, AVIDs etc.
Future changes to contact details
Should you change your address, phone numbers, email address etc. in the future, you will need to notify
CASA as soon as possible so that the details recorded against your ARN can be updated. The easiest and
quickest way to do this is through the CASA Self Service facility.
Where do I send my application?
Please forward the form plus any other required documents to the CASA Licensing and Registration Centre
(CLARC). Email is CASA’s preferred means of contact by email to clarc@casa.gov.au
Mail to: CASA Licencing and Registration Centre
GPO Box 2005
CANBERRA ACT 2601
What happens if the application is completed incorrectly or I forget to include identification?
At the very minimum, there will be a delay while CASA requests additional information. In most cases, your
form will be rejected and returned for alteration.
What happens once my ARN is created?
CASA will notify you of your ARN by email. Please note where an email address has not been provided
notification will be sent by postal mail.
Release of ARN details to a third party
If you wish CASA to release your ARN to a third party, such as a flying school, you must complete and submit
a CASA Form 078 with this application. Once the ARN is raised, CASA will inform the nominated party, as
well as the applicant, of the ARN.
Who should I contact if I have a problem?
Contact CLARC, the CASA Licensing and Registration Centre, for assistance:
Phone: 131 757 (within Australia)
Email: clarc@casa.gov.au

Form 1162 12/2017 Aviation Reference Number (ARN) Application - Individual Page 2 of 2